Glycemic control and outcomes of hospitalization in non-critically ill patients with Type 2 diabetes admitted with cardiac problems or infections.
Endocr Pract. 2014 Aug 6;:1-14
Authors: Draznin B, Wang Y, Seggelke S, Hawkins RM, Gibbs J, Bridenstine M, Rasouli N, Wang CL
Abstract
Objectives: While the importance of glycemic control is well established for patients with diabetes hospitalized for surgical problems, it has not been supported by clinical studies for patients with diabetes hospitalized on the medical floors.Research Design and Methods: We conducted a retrospective study of 378 patients with Type 2 diabetes admitted for cardiac or infectious disease (ID) diagnosis between Sep 1, 2011 and August 1, 2012. Exclusion criteria included Type 1 diabetes, admission to the intensive care unit (ICU), hospital stay shorter than 3 days, and daily glucocorticoid dose greater than 20 mg of methylprednisolone. The primary composite outcome included death during hospitalization, ICU transfer, initiation of enteral or parenteral nutrition, line infection, deep vein thrombosis, pulmonary embolism, rise in plasma creatinine by 1 or over 2 mg/dl, new infection, an infection lasting for more than 20 days, and re-admission within 30 days and between 1 and 10 months after discharge.Results: Patients were stratified by mean blood glucose (BG) level: Group 1 had mean BG of less than 180 mg/dl (n=286, mean BG 142±23 mg/dl) while Group 2 had mean BG levels greater than 181 mg/dl (n=92, mean BG 218±34 mg/dl, p<0.0001). Group 2 had a 46% higher occurrence of the primary outcome (p<0.0004). The rate of unfavorable events was greater in cardiac and ID patients with worse glycemic control (Group 2).Conclusions: Our data strongly support a positive influence of better glycemic control (average glycemia <180 mg/dl or 10mMol/l) on outcomes of hospitalization in patients with Type 2 diabetes.
PMID: 25100383 [PubMed - as supplied by publisher]